Example: bankruptcy

PRACTICE & NURSING Automatic Intravenous Pig gyback ...

NURSINGPRACTICE & Caple, RN, BSN, MSHSC inahl Information Systems, Glendale, CAReviewersEliza Schub, RN, BSNC inahl Information Systems, Glendale, CASara Richards, MSN, RNCinahl Information Systems, Glendale, CANursing PRACTICE CouncilGlendale Adventist Medical Center,Glendale, CAEditorDiane Pravikoff, RN, PhD, FAANC inahl Information Systems, Glendale, CAAugust 14, 2015 Published by Cinahl Information Systems, a division of EBSCO Information Services. Copyright 2015, Cinahl Information Systems. All rightsreserved. No part of this may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or byany information storage and retrieval system, without permission in writing from the publisher. Cinahl Information Systems accepts no liability for adviceor information given herein or errors/omissions in the text.

› An intravenous (I.V.) “piggyback,” or secondary infusion, is the administration of ... The use of needle-free adaptors significant lowers the risk for patient and reduces staff injury resulting from needlesticks (FDA Safety Alert, 1992) ... a pump that will deliver at only a single programmed rate, the piggyback must be hung higher than ...

Tags:

  Automatic, Only, Intravenous, Automatic intravenous pig gyback, Gyback

Information

Domain:

Source:

Link to this page:

Please notify us if you found a problem with this document:

Other abuse

Transcription of PRACTICE & NURSING Automatic Intravenous Pig gyback ...

1 NURSINGPRACTICE & Caple, RN, BSN, MSHSC inahl Information Systems, Glendale, CAReviewersEliza Schub, RN, BSNC inahl Information Systems, Glendale, CASara Richards, MSN, RNCinahl Information Systems, Glendale, CANursing PRACTICE CouncilGlendale Adventist Medical Center,Glendale, CAEditorDiane Pravikoff, RN, PhD, FAANC inahl Information Systems, Glendale, CAAugust 14, 2015 Published by Cinahl Information Systems, a division of EBSCO Information Services. Copyright 2015, Cinahl Information Systems. All rightsreserved. No part of this may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or byany information storage and retrieval system, without permission in writing from the publisher. Cinahl Information Systems accepts no liability for adviceor information given herein or errors/omissions in the text.

2 It is merely intended as a general informational overview of the subject for the healthcareprofessional. Cinahl Information Systems, 1509 Wilson Terrace, Glendale, CA 91206 Automatic Intravenous "Piggyback": Setting UpWhat is an Automatic Intravenous Piggyback ? An Intravenous ( ) piggyback, or secondary infusion, is the administration ofmedication that is diluted in a small volume of solution ( , 50 250 ml in a minibag)through an established primary infusion line. The piggyback can be administered bygravity or by infusion pump. The information that follows focuses on piggybackadministration by the automated method of infusion pump What: The piggyback set-up involves halting infusion of the primary solution whilethe piggybacked solution infuses and resuming infusion of the primary solution wheninfusion of the piggybacked solution is completed.

3 Although the two solutions do notinfuse simultaneously ( , tandem infusion), they must be compatible because thepiggyback is connected to and infuses through the primary tubing How: The piggyback solution is typically hung higher than the primary infusion bagand is connected by a short length of tubing to the upper Y-port on the primary infusionline . The pump is programmed to deliver the piggyback at the prescribed rate, whichis usually over a period of 30 90 minutes. Depending on the model, the infusion pumpcan be programmed to automatically revert to a rate that is appropriate for the primaryinfusion or the nurse can change the rate manually Where: Piggybacks can be used in any location where infusions are administered Who: Nurse clinicians are principally responsible for setting up and monitoring theinfusion of piggybacks.

4 Assistive personnel can alert the nurse of abnormalities inpatient presentation that may signal complications associated with infusion, butthe responsibility of setting up or maintaining infusions should not be delegated toassistive personnelWhat is the Desired Outcome of Using the PiggybackMethod? The desired outcome of using the piggyback method is to administer the prescribeddose of medication diluted in a small amount of solution by slow infusion and withoutthe development of complications related to therapyWhy is an Piggyback Important? The piggyback method is often preferred when serial intermittent doses of an are required because the continuous infusion indicates that the line ispatent and functioning properly Unlike the push method, the automated piggyback method of infusion pumpallows for dilution and slower, more precise administration of medication, whichdecreases risk associated with rapid infusion ( , phlebitis and infiltration resulting fromrapid administration of highly concentrated medication)

5 A piggyback permits serial administration of medications without requiring that thetubing be repeatedly disconnected from the patient and replaced, which can increase riskfor infectionFacts and Figures Risk for needlesticks and cotransmission of hepatitis B, HIV, and other blood-borne pathogens is 6 times higher whenperforming piggyback procedures and intermittent medication administration than when delivering medication push. The use of needle-free adaptors significant lowers the risk for patient and reduces staff injury resulting fromneedlesticks (FDA Safety Alert, 1992) Cochrane investigators who compared intermittent antibiotic infusions with continuous or extended ( , over a period of3 24 hours) antibiotic infusions found no difference in patient mortality, clinical cure, infection status after treatment, andsafety between the two methods.

6 The researchers were unable to recommend continuous or extended antibiotic infusionbecause there was no added benefit over standard, intermittent antibiotic administration (Shiu et al., 2013)What You Need to Know Before Setting Up an Piggyback The term piggyback is used because the piggyback is hung higher than the primary infusion bag and the solution isdelivered by gravity, which allows it to be infused while infusion of the primary solution is temporarily halted When a piggyback using an Automatic infusion pump, it may or may not be necessary to hang the piggyback higher thanthe primary infusion bag. Smart pumps are pumps that are programmed to actively deliver the piggyback as a secondaryinfusion, and then automatically revert to the primary solution and rate, regardless of the height of the solution.

7 When usinga pump that will deliver at only a single programmed rate, the piggyback must be hung higher than the primary infusion toallow the piggyback to infuse by gravity. To avoid confusion, hanging the piggyback medication higher than the primaryinfusion bag can be performed regardless of the pump used The term piggyback is sometimes used to describe infusion of a small bag of solution that has been directly connectedto an intermittent access device ( , saline lock). However, this set-up is more appropriately described as an intermittentprimary infusion instead of a piggyback The clinician should demonstrate competence in adherence to facility infection control protocols and standard precautions, assessment, primary infusion set-up and use of an infusion pump, and medication administration When administering medications by piggyback, adherence to the six rights of medication administration is include verifying the right patient, the right drug, the right dose, the right time, the right route, and the rightdocumentation To provide safe medication administration.

8 The nurse must verify compatibility between the medication and diluentcontained in the piggyback and between the piggyback and primary solution Piggybacks contain medication that is mixed in a small amount of diluent ( , 50 250 ml of sodium chlorideor dextrose 5% in water). Depending on facility protocol, the piggyback may be mixed and prepared by a licensedpharmacist or by the nurse clinician. The nurse should refer to the pharmacy department and/or a drug informationresource for assistance in selecting the appropriate type and volume of diluent if responsible for mixing and preparing apiggyback The piggyback and primary solutions do not infuse simultaneously, but must be compatible because the piggybackis connected to and infuses in the primary tubing. For the piggyback and primary infusion to be compatible, both themedications/additives and diluents of both solutions must be compatible Familiarity with equipment that is used to administer solutions and medications is required The primary infusion tubing is equipped with a check valve that allows the primary infusion to restart when infusion of thepiggyback is complete.

9 Additional functions of the check valve include preventing air from entering the system after the piggyback has infused preventing the piggyback from running dry disallowing significant mixing of the primary and piggyback solutions Familiarity with potential complications of medication administration is important. These include phlebitis ( , venous inflammation), which is characterized by swelling of the vein and redness and warmth of theoverlying skin infiltration ( , leaking of fluid outside of the vein and in the surrounding tissue), which is characterized by blanching andcoolness of the skin, edema, and pain allergy, which is characterized by itching, swelling, rash, and/or hives Errors that can occur during piggyback infusion include over-infusion or under-infusion of medication, incorrect tubingsetup, and errors in programming the infusion pump.

10 Carefully review and PRACTICE the procedure for piggyback set-up, andoperation of the designated infusion pump prior to piggyback administration Preliminary steps that should be performed prior to setting up an piggyback include the e following: Review facility protocol for medication administration Review the patient s medical record for information on allergies ( , to latex, medications, or other substances); use alternative materials, as appropriate current medications the treating clinician s order for the medication to be administered Gather the necessary supplies, which typically include the following: Personal protective equipment (PPE; , nonsterile gloves; use additional PPE [ , gown, mask, eye protection] ifexposure to body fluids is anticipated) Primary infusion set Secondary infusion set, which usually includes an extension hook Primary solution Compatible piggyback (secondary)


Related search queries